Using non-invasive biomarkers to identify hepatic fibrosis in people with type 2 diabetes mellitus: the Edinburgh type 2 diabetes study
BACKGROUND & AIMS: It is difficult to determine the different stages of non-alcoholic fatty liver disease without the use of invasive liver biopsy. In this study we investigated five non-invasive biomarkers used previously to detect hepatic fibrosis and determined the level of agreement between...
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Elsevier
2014
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| Online Access: | https://eprints.nottingham.ac.uk/51981/ |
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| author | Morling, Joanne R. Fallowfield, Jonathan A. Guha, Indra Neil Nee, Lisa D. Glancy, Stephen Williamson, Rachel M. Robertson, Christine M. Strachan, Mark W.J. Price, Jackie F. |
| author_facet | Morling, Joanne R. Fallowfield, Jonathan A. Guha, Indra Neil Nee, Lisa D. Glancy, Stephen Williamson, Rachel M. Robertson, Christine M. Strachan, Mark W.J. Price, Jackie F. |
| author_sort | Morling, Joanne R. |
| building | Nottingham Research Data Repository |
| collection | Online Access |
| description | BACKGROUND & AIMS: It is difficult to determine the different stages of non-alcoholic fatty liver disease without the use of invasive liver biopsy. In this study we investigated five non-invasive biomarkers used previously to detect hepatic fibrosis and determined the level of agreement between them in order to inform future research.
METHODS: In the Edinburgh Type 2 Diabetes Study, a population-based cohort aged 60-74 years with type 2 diabetes, 831 participants underwent ultrasound assessment for fatty liver and had serum aspartate aminotransferase to alanine aminotransferase ratio (AST/ALT), aspartate to platelet ratio index (APRI), European Liver Fibrosis panel (ELF), Fibrosis-4 Score (FIB4) and liver stiffness measurement (LSM) measured.
RESULTS: Literature based cut-offs yielded marked differences in the proportions of the cohort with probable liver fibrosis in the full cohort. Agreement between the top 5% of the distribution for each biomarker pair was poor. APRI and FIB4 had the best positive agreement at 76.4%, but agreement for all of the other serum biomarker pairs was between 18% and 34%. Agreement with LSM was poor (9-16%).
CONCLUSIONS: We found poor correlation between the five biomarkers of liver fibrosis studied. Using the top 5% of each biomarker resulted in good agreement on the absence of advanced liver disease but poor agreement on the presence of advanced disease. Further work is required to validate these markers against liver biopsy and to determine their predictive value for clinical liver-related endpoints, in a range of different low and high risk population groups. |
| first_indexed | 2025-11-14T20:22:38Z |
| format | Article |
| id | nottingham-51981 |
| institution | University of Nottingham Malaysia Campus |
| institution_category | Local University |
| last_indexed | 2025-11-14T20:22:38Z |
| publishDate | 2014 |
| publisher | Elsevier |
| recordtype | eprints |
| repository_type | Digital Repository |
| spelling | nottingham-519812020-05-04T16:42:39Z https://eprints.nottingham.ac.uk/51981/ Using non-invasive biomarkers to identify hepatic fibrosis in people with type 2 diabetes mellitus: the Edinburgh type 2 diabetes study Morling, Joanne R. Fallowfield, Jonathan A. Guha, Indra Neil Nee, Lisa D. Glancy, Stephen Williamson, Rachel M. Robertson, Christine M. Strachan, Mark W.J. Price, Jackie F. BACKGROUND & AIMS: It is difficult to determine the different stages of non-alcoholic fatty liver disease without the use of invasive liver biopsy. In this study we investigated five non-invasive biomarkers used previously to detect hepatic fibrosis and determined the level of agreement between them in order to inform future research. METHODS: In the Edinburgh Type 2 Diabetes Study, a population-based cohort aged 60-74 years with type 2 diabetes, 831 participants underwent ultrasound assessment for fatty liver and had serum aspartate aminotransferase to alanine aminotransferase ratio (AST/ALT), aspartate to platelet ratio index (APRI), European Liver Fibrosis panel (ELF), Fibrosis-4 Score (FIB4) and liver stiffness measurement (LSM) measured. RESULTS: Literature based cut-offs yielded marked differences in the proportions of the cohort with probable liver fibrosis in the full cohort. Agreement between the top 5% of the distribution for each biomarker pair was poor. APRI and FIB4 had the best positive agreement at 76.4%, but agreement for all of the other serum biomarker pairs was between 18% and 34%. Agreement with LSM was poor (9-16%). CONCLUSIONS: We found poor correlation between the five biomarkers of liver fibrosis studied. Using the top 5% of each biomarker resulted in good agreement on the absence of advanced liver disease but poor agreement on the presence of advanced disease. Further work is required to validate these markers against liver biopsy and to determine their predictive value for clinical liver-related endpoints, in a range of different low and high risk population groups. Elsevier 2014-02-28 Article PeerReviewed Morling, Joanne R., Fallowfield, Jonathan A., Guha, Indra Neil, Nee, Lisa D., Glancy, Stephen, Williamson, Rachel M., Robertson, Christine M., Strachan, Mark W.J. and Price, Jackie F. (2014) Using non-invasive biomarkers to identify hepatic fibrosis in people with type 2 diabetes mellitus: the Edinburgh type 2 diabetes study. Journal of Hepatology, 60 (2). pp. 384-391. ISSN 1600-0641 Aged; Alanine Transaminase; Aspartate Aminotransferases; Biomarkers; Cohort studies; Diabetes Mellitus Type 2; Elasticity imaging techniques; Fatty Liver; Liver Cirrhosis; Non-alcoholic fatty liver disease; Platelet count; Predictive value of tests https://www.sciencedirect.com/science/article/pii/S0168827813007423?via%3Dihub doi:10.1016/j.jhep.2013.10.017 doi:10.1016/j.jhep.2013.10.017 |
| spellingShingle | Aged; Alanine Transaminase; Aspartate Aminotransferases; Biomarkers; Cohort studies; Diabetes Mellitus Type 2; Elasticity imaging techniques; Fatty Liver; Liver Cirrhosis; Non-alcoholic fatty liver disease; Platelet count; Predictive value of tests Morling, Joanne R. Fallowfield, Jonathan A. Guha, Indra Neil Nee, Lisa D. Glancy, Stephen Williamson, Rachel M. Robertson, Christine M. Strachan, Mark W.J. Price, Jackie F. Using non-invasive biomarkers to identify hepatic fibrosis in people with type 2 diabetes mellitus: the Edinburgh type 2 diabetes study |
| title | Using non-invasive biomarkers to identify hepatic fibrosis in people with type 2 diabetes mellitus: the Edinburgh type 2 diabetes study |
| title_full | Using non-invasive biomarkers to identify hepatic fibrosis in people with type 2 diabetes mellitus: the Edinburgh type 2 diabetes study |
| title_fullStr | Using non-invasive biomarkers to identify hepatic fibrosis in people with type 2 diabetes mellitus: the Edinburgh type 2 diabetes study |
| title_full_unstemmed | Using non-invasive biomarkers to identify hepatic fibrosis in people with type 2 diabetes mellitus: the Edinburgh type 2 diabetes study |
| title_short | Using non-invasive biomarkers to identify hepatic fibrosis in people with type 2 diabetes mellitus: the Edinburgh type 2 diabetes study |
| title_sort | using non-invasive biomarkers to identify hepatic fibrosis in people with type 2 diabetes mellitus: the edinburgh type 2 diabetes study |
| topic | Aged; Alanine Transaminase; Aspartate Aminotransferases; Biomarkers; Cohort studies; Diabetes Mellitus Type 2; Elasticity imaging techniques; Fatty Liver; Liver Cirrhosis; Non-alcoholic fatty liver disease; Platelet count; Predictive value of tests |
| url | https://eprints.nottingham.ac.uk/51981/ https://eprints.nottingham.ac.uk/51981/ https://eprints.nottingham.ac.uk/51981/ |